Introduction
The association between e-cigarette use and chronic bronchitis, emphysema, and chronic
obstructive pulmonary disease has not been studied thoroughly, particularly in populations
defined by concomitant combustible smoking status.
Methods
Using pooled 2016 and 2017 data from the Behavioral Risk Factor Surveillance System,
investigators studied 705,159 participants with complete self-reported information
on e-cigarette use, combustible cigarette use, key covariates, and chronic bronchitis,
emphysema, or chronic obstructive pulmonary disease. Current e-cigarette use was the
main exposure, with current use further classified as daily or occasional use. The
main outcome was defined as reported ever having a diagnosis of chronic bronchitis,
emphysema, or chronic obstructive pulmonary disease. For all the analyses, multivariable
adjusted logistic regression was used, with the study population stratified by combustible
cigarette use status (never, former, or current). All the analyses were conducted
in 2019.
Results
Of 705,159 participants, 25,175 (3.6%) were current e-cigarette users, 64,792 (9.2%)
current combustible cigarette smokers, 207,905 (29.5%) former combustible cigarette
smokers, 432,462 (61.3%) never combustible cigarette smokers, and 14,036 (2.0%) dual
users of e-cigarettes and combustible cigarettes. A total of 53,702 (7.6%) participants
self-reported chronic bronchitis, emphysema, or chronic obstructive pulmonary disease.
Among never combustible cigarette smokers, current e-cigarette use was associated
with 75% higher odds of chronic bronchitis, emphysema, or chronic obstructive pulmonary
disease compared with never e-cigarette users (OR=1.75, 95% CI=1.25, 2.45), with daily
users of e-cigarettes having the highest odds (OR=2.64, 95% CI=1.43, 4.89). Similar
associations between e-cigarette use and chronic bronchitis, emphysema, or chronic
obstructive pulmonary disease were noted among both former and current combustible
cigarette smokers.
Conclusions
The results suggest possible e-cigarette–related pulmonary toxicity across all the
categories of combustible cigarette smoking status, including those who had never
smoked combustible cigarettes.
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Article Info
Publication History
Published online: January 01, 2020
Identification
Copyright
© 2019 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
